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This study aims to develop a hierarchical model that uncovers the relationships between challenges confronting Africa's organ transplant supply chain systems.

Eleven challenges (variables) were identified after a comprehensive review of the existing literature. The contextual interactions among these variables were analysed from the perspectives of health-care stakeholders in two sub-Saharan Africa (SSA) countries (Nigeria and Uganda), using Delphi-interpretive structural modelling-cross-impact matrix multiplication applied to classification (MICMAC) techniques.

The findings reveal that weak regulatory frameworks, insufficient information systems and a lack of necessary skills make it challenging for critical actors to perform the tasks effectively. The interaction effects of these challenges weaken organ supply chains and make it less efficient, giving rise to negative externalities such as black markets for donated organs and organ tourism/trafficking.

This paper establishes a solid foundation for a critical topic that could significantly impact human health and life once the government or non-profit ecosystem matures. The MICMAC analysis in this paper provides a methodological approach for future studies wishing to further develop the organ supply chain structural models.

The study provides valuable insights for experts and policymakers on where to prioritise efforts in designing interventions to strengthen organ transplantation supply chains in developing countries.

This study is one of the first to empirically examine the challenges of organ transplant supply chains from an SSA perspective, including theoretically grounded explanations from data collected in two developing countries.

Organ donation and transplantation services represent a microcosm of modern healthcare organisations. They are complex adaptive systems. They face perpetual problems of matching supply and demand. They operate under fierce time and resource constraints. And yet they have received relatively little attention from a systems perspective. The purpose of this paper is to consider some of the fundamental issues in evaluating, improving and policy reform in such complex systems.

The paper advocates an approach based on programme theory evaluation.

The paper explains how the death to donation to transplantation process depends on the accumulation of series of embedded, institutional sub-processes. Evaluators need to be concerned with this whole system rather than with its discrete parts or sectors. Policy makers may expect disappointment if they seek to improve donation rates by applying nudges or administrative reforms at a single point in the implementation chain.

These services represent concentrated, perfect storms of complexity and the paper offers guidance to practitioners with bio-medical backgrounds on how such services might be evaluated and improved. For the methodological audience the paper caters for the burgeoning interest in programme theory evaluation while illustrating the design phase of this research strategy.

Discusses the need for reliable research‐based evidence detailing the costs and benefits provided by different operational and strategic structures of renal replacement therapy. Suggests that in choosing the most appropriate form of dialysis the treatment options may be limited for clinical, practical or financial reasons. Proposes that the renal services must support patients in empowering them to make informed choices concerning the dialysis modality which offers them the highest quality of life. Brings into perspective the need for a balance between patients’ quality of life and the financial constraints on the NHS.

Tissue engineering (TE) offers treatments for chronic, life threatening, degenerative illnesses and possibilities for restoring cellular or organ functions that have been lost due to injuries or hereditary conditions. However, a prerequisite for the use of TE products as part of future therapies is the development of strategies for safe and efficient supply chain management and versatile services spanning from product development to a follow‐up period of possibly decades. The present study aims to explore the future needs for services and extended supply chains for safe delivery of health care, procurement, distribution and long‐term follow‐up of TE products and therapies.

Studies in operational disciplines and coordination systems for different types of supply chains and service networks are used to formulate a framework for developing services throughout product lifecycle. Case examples of TE products are presented to demonstrate complexity, microbial risks, services and long‐term follow‐up. The role of logistics and the necessary services are identified for products classified into experimental, therapy and standard products.

The paper finds that, through the stages, the importance of logistics increases from an enabler to becoming a strategic tool, emphasizing logistics requirements in establishing a viable TE supply chain. New dimensions to existing service operations frameworks are needed where proactive tissue sourcing, long follow‐up periods, short shelf life and biological risks call for enforcing flexible services with tissue banks, detailed tracing, authorization and regulation.

The paper presents the discovery of the logistics services and service institutions that will become imperatives for the future success of TE products and therapies.

Patients, when using healthcare services, (co)create value by integrating their own resources with those of a range of stakeholders. These resource integration activities, however, require different types of skills and effort from the patients, and different types of interactions with stakeholders, while also having different effects on patients' well-being. The purpose of the present study is to develop a better understanding of why some patients are better able or willing to perform resource integration activities that impact their well-being. To reach this objective, barriers and facilitators of these activities in their interactions with various stakeholders were identified.

The study uses a multiple case study design. Individual patients having received a lung transplant, together with their entourage (family, medical professionals, other patients) each represent a case. In-depth interviews were conducted with the patients and with various categories of stakeholders in their service delivery network who were relevant to their experience and with whom they integrated their resources.

The study identifies three levels on which barriers and facilitators of the resource integration process occur: the individual, relational and systemic level. Factors on these levels affect different aspects of the process.

This study takes a systems perspective and investigates how various systemic factors and stakeholders conduce or inhibit healthcare service users to perform resource integration activities, especially focusing on those activities that strongly affect their well-being.

Environmental sustainability in health care is an important issue due to the limited available healthcare resources and increase in demand. For instance, organ recycling and transplantation may reduce the increasing pressure on healthcare resources. The purpose of this paper is to set out to identify and interrelate the inhibitors that significantly influence the recycling of human organs and their implications to the environment in developing economies such as India.

The study uses Delphi–ISM–regression, a three-step method, to investigate the possible reasons for the poor supply chain efficiency of organ recycling and to explore the consequence of excessive use of healthcare resources on the environment. The Delphi technique facilitates the identification, synthesis, and prioritization of the inhibitors. Then, using focused group discussion, the interpretive structure modeling (ISM) presents the interaction among the inhibitors into a hierarchy. Further, on the basis of 257 valid responses received on the structured survey instrument, the regression model examines the influence of identified constructs on one of the identified root causes.

The ISM presents the hierarchy-based model that depicts high driving power and low dependence inhibitors leading to reduced organ recycling rate. “Negative Intentions of family members” toward organ donation t “Willingness to discuss with family” and “Perceived Behavioral Control” emerged as the significant factors influencing organ recycling rate, which adversely impact the environment sustainability.

The patients on the organ waiting list put pressure on the availability of medical resources and, ultimately, on the environment through the consumption of different drugs and disposable of medical wastes. The study suggests policymakers and hospitals improve on the existing policies for an efficient supply chain of human organ recycling. The Indian situation echoes the situation in most of the emerging economies, and similar solutions can apply there too.

This paper aims to examine emotional labour in the work of frontline staff (FLS) of the Canadian Blood Services' Cord Blood Bank (CBB), contributes to understandings of emotional labour by allied healthcare workers and suggests implications for healthcare managers.

Qualitative interviews with 15 FLS were conducted and analyzed as part of a process evaluation of donor recruitment and cord blood collection in Canada.

Emotional labour with donors and hospital staff emerged as a vital component of FLS' donor recruitment and cord blood collection work. Emotional labour was performed with donors to contribute to a positive birthing experience, facilitate communication and provide support. Emotional labour was performed with hospital staff to gain acceptance and build relationships, enlist support and navigate hierarchies of authority.

The results indicate that FLS perform emotional labour with women to provide donor care and with hospital staff to facilitate organizational conditions. The findings are based on FLS' accounts of their work and would be enhanced by research that examines the perspectives of donors and hospital staff.

Attention should be paid to organizational conditions that induce the performance of emotional labour and may add to FLS workload. Formal reciprocal arrangements between FLS and hospital staff may reduce the responsibility on FLS and enable them to focus on recruitment and collections.

This paper addresses a gap in the healthcare management literature by identifying the emotional labour of allied healthcare workers. It also contributes to the cord blood banking literature by providing empirically grounded analysis of frontline collection staff.

This paper's aim is to identify existing and developing new concepts of organization, management, and leadership at a large European university hospital; and to evaluate whether mixed qualitative‐quantitative methods with both internal and external input can provide helpful views of the possible future of large health care providers.

Using the Delphi method in semi‐structured, semi‐quantitative interviews, with managers and employees as experts, the authors performed a vertical and a horizontal internal analysis. In addition, input from innovative faculties in other countries was obtained through structured power questions. These two sources were used to create three final scenarios, which evaluated using traditional strategic planning methods.

There is found a collaboration scenario in which faculty and hospital are separated; a split scenario which divides the organization into three independent hospitals; and a corporation scenario in which corporate activities are bundled in three separate entities.

In complex mergers of knowledge‐driven organizations, the employees of the own organization (in addition to external consultants) might be tapped as a knowledge resource to successful future business models.

The paper uses a real world consulting case to present a new set of methods for strategic planning in large health care provider organizations.

To underscore the significance of international health care management, we focus on three themes: the problem of global blindness; global health care challenges and opportunities; and learning from international health care management. The problem of global blindness highlights how health care managers’ inattentional blindness to competitors’ operational performance and market strategies lead to avoidable and expensive failures. To address global challenges and opportunities, health care organizations are employing two different strategies: (1) building and marketing a world-class health care facility internationally, and (2) organizing and integrating multinational health care operations. The first strategy exploits the medical-tourism market. The second strategy requires either multinational health care networks or transnational health care organizations. One of the lessons to be learned from international health care management is that an organization can create a meta-national competitive advantage. Another lesson is that by examining best practices from around the world, health care organizations can obtain new insights and become more innovative within their home markets. A corollary and third lesson is that while health care organizations can learn a great deal from examining international best clinical practices, sometimes the most important management lessons are lost in clinical translations. The fourth and last lesson is that worst cases – serious international management failures – offer perhaps the most valuable insights into the role of culture, complexity, and leadership for health care organizations.

This paper aims to address problems in patient flow and identify the reasons behind extensive wait time at a public liver transplant outpatient clinic in an education and research hospital through the use of Lean health-care theories.

This paper opted for the application of Lean thinking and action research strategy. Data were collected through personal observations, interviews with users and team brainstorming. A value stream map was developed, improvement possibilities were identified and non-value-added activities were attempted to be eliminated.

Significant problems were identified and improvements were implemented and measured. The major remedial measures were: change the scheduling pattern, create a flow chart and a Kanban visual guide for medical students. In addition, an institutional change in the medical appointment scheduling software collaborated in the reduction of time and in the patient’s displacement. The waiting time was reduced by 4.5 h, and the per cent complete and accurate increased by 50 per cent.

The flow was redesigned, and a culture of continuous improvement was introduced. Visiting the place where work was being done, leaders identified and created more value to the process without significant costs. The Gemba Walk was a powerful tool, interacting with people and processes in a Kaizen spirit.

Public health services in developing countries are one of the most deprived social needs of good practice. It will be useful for those who need examples about how to apply Lean tools in health care.